Table 5.
Target therapies (part III).
| Electrolyte disorder | Drug | Incidence (%) Type of study | Mechanism(s) |
|---|---|---|---|
| Hypocalcemia |
Cetuximab, Panitumumab Lumretuzumab, Pertuzumab (combined with paclitaxel) Imatinib Sorafenib Nilotinib Erlotinib, Axitinib, Sunitinib |
17 (D) (99) 14 (D) (98) 40 (A,B) (109) |
Hypomagnesemia-related hypoparathyroidism (99) Direct effect on tyrosine kinase c-Kit of tubular cells (109); low-voltage-activated T channels blockade (110, 111) Endoplasmic reticulum stress with calcium mobilization (112) Immune-mediated parathyroid glands destruction; interference with CaSRs (113) Unclear (114, 115) |
| Hypophosphatemia |
TKI
Sorafenib Combined with Capecitabine Vemurafenib, Dabrafenib Proteasome Inhibitors (Bortezomib, Oprozomib Carfilzomib) Lenalidomide mTOR inhibitors (temsirolimus) MoAbs (Nivolumab, Bevacizumab, Etaricizumab) Lumretuzumab, Pertuzumab (combined with paclitaxel) Mirvetuximab Soravtansine |
23 (<2.0 mg/dl) (D) (116) 40 (A, B) (109) 2.3 (<2.0 mg/dl) (D) (117) 17(D) (98) 25 (<2.0 mg/dl) (D) (118) |
Bone Turnover inhibited; proximal tubule damage by PDGFR blockade (119, 120) Vitamin D malabsorption due to drug-induced secretory diarrhea (121) Acquired FS (120, 122) Acquired FS (123) Acquired FS (?) (124) Phosphate wasting due to acute tubular necrosis (34) Acquired FS (?) (79, 100, 117) Vitamin D malabsorption due to drug-induced secretory diarrhea (98) Vitamin D malabsorption due to drug-induced secretory diarrhea (118) |
| Hyperphosphatemia |
MoABS (Brentuximab, Obinutuzumab,Otlertuzumab, Ibritumomab,Ofatumomab)
TKI Proteasome Inhibitors Lenalidomide and CAR-T cell |
n.a. | Tumor Lysis Syndrome (28, 125) |
Incidence and type of study column: the letter after the percentage indicates the type of evidence available: A isolated case; B case series; C pharmacovigilance notifications or registry; D observational study, clinical trial, metanalysis of clinical trials. n.a. not available. References in bracket square. CAR-T, Chimeric Antigen Receptor-T; CaSR=calcium sensing receptor; c-Kit, type III receptor tyrosine kinase; FS= Fanconi Syndrome; MoAbs, Monoclonal Antibodies; mTOR= mammalian target of Rapamycin; PDGFR, Platelet Derived Growth Factor Receptor; PTH, Parathyroid hormone; TKI, Tyrosine Kinase Inhibitors.